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11111111111111111 1111111111111111111111111111111111111111111 • 0 1 2 3 4 5- 6 7 8 9* PART 0: SCHEDULE OF U.S. DOLLAR LIBOR -BASED INSTRUMENTS DOCUMENTATION TO SUPPORT YOUR TRANSACTIONS IN U.S. DOLLAR LIBOR -BASED INSTRUMENTS IS NOT REQUIRED AT THIS TIME, HOWEVER, THE CLAIMS ADMINISTRATOR MAY ASK YOU TO PROVIDE DOCUMENTATION TO SUBSTANTIATE YOUR TRANSACTIONS DURING AUDITING. INSTRUCTIONS: List all U.S. Dollar LIBOR -Based Instruments you purchased in the United States directly from a Defendant (or a Defendant's subsidiary or affiliate), and which you owned any time during the period August 2007 through May 2010 (Class Period). You should only list the information for the leg of the swap (or bond) where you received LIBOR -based payments from a Defendant during the Class Period. The Settlement does not include U.S. Dollar LIBOR -based instruments that include only a term, provision, or obligation or right to pay interest based on the U.S. Dollar LIBOR rate, such as business, home, student, or car loans, or credit cards. If you have an instrument for which you cannot fit the terms in the space below, attach the instrument separately and describe the terms of the LIBOR - based payments on a separate page. If you do not know every term for a transaction, fill in the form with as many fields for which you know the answer — the Claims Administrator will attempt to fill in any blanks, but may reject the claim if it is unable to. An example for how to fill out the form for a plain -vanilla swap is: Defendant Paying LIBOR Maturity/ Effective Date Cancellation Date (Month/DaylYear) (Month/Day/Year) UBS AG 9/10/06 9/10/21 Tenor and Currency of LIBOR 3 -Month USD LIBOR Frequency Notional of LIBOR Amount Payment Periods $20 Million Quarterly Non -Standard Terms Actual/360 N146950N Page 2 of 6 P169